GRASSROOTS: The GMT Initiative Blog

Grassroots reports on the work of amfAR-supported research teams and advocates responding to the devastating impact of HIV among gay men, other men who have sex with men, and transgender individuals (collectively, GMT).

The idea of a transsexual identity did not exist in the Dominican Republic until recently. LGBT communities mainly considered a biological man dressed in woman’s clothing to be a transvestite or, worse, a drag queen.

D.R. has an overall HIV prevalence of 0.8 percent, but a recent study shows that 25 percent of female transsexual sex workers have HIV. Many have been victims of abuse from early on and have experienced sexual coercion and/or violence; very few have had access to education or prevention or treatment centers equipped to work with them. Mental health services for these vulnerable women are almost nonexistent.

Seeing the hardships facing female trans sex workers, COIN, an organization in Santo Domingo that provides sexual and reproductive health services, identified them as a priority for HIV prevention efforts and began offering them services. The program has been successful in gaining the trust of an extremely cautious and guarded community.

“I was a sex worker for a long time, but now I am a social worker,” proclaimed Nairobi, a leader in the female trans sex worker community. “I work with the girls and share my experiences so their lives can be better. One day, they won’t have to depend on sex for their survival and HIV can be less of a threat to their lives.”

Every two weeks, Nairobi and other health promoters go to the sites where the women work to notify them that COIN’s mobile clinic will be coming the following day. One woman told me, “I never miss the mobile clinic days. Even if that day is my day off, I will come.” The mobile clinic team seems to know every detail of these women’s lives. Every scar has a story to it; every wound a painful memory.

Every week at the center the women come and speak with a psychologist on subjects ranging from self-confidence to social integration at a workshop called “An Afternoon with Mama.” The women act as a family, supporting and protecting one another. For some of them, this is the only family they have.